Using Your Health Insurance
VERIFY YOUR MENTAL HEALTH/BEHAVIORAL HEALTH BENEFITS
VERIFY YOUR MENTAL HEALTH/BEHAVIORAL HEALTH BENEFITS
Using your insurance benefits for therapy sessions may seem overwhelming (it does not have to be) if you do not understand what your insurance plan covers. You need to understand your insurance benefits (such as deductible amount, copayments, coinsurance, or any other requirements for coverage) and verify with your insurance carrier if your insurance benefits cover outpatient mental health visits before scheduling a therapy session.
We only accept certain insurance plans. It is your responsibility to verify with your insurance to ensure you are insured by a plan with the insurance that we are in-network with. Before you schedule a session with us, you need to contact your insurance and (1) verify that you can see your provider in-network and (2) how much it would cost you to see your provider.
*We utilize a company, Headway, to accept commercial insurance plans and billing is done through Headway for Virginia Residents. Headway's rates are based on their contracted agreement with the insurance companies.
Provider's Name and NPI#. Ask your provider for their registered name in the health care system, and National Provider Identification (NPI) number.
Ni Hsieh. NPI #1528604600
Full name and date of birth of the subscriber. If you are on your spouse's or parents' health insurance plan, you may need the information.
Call the number on the back of your insurance card and ask your insurance customer representative about your "mental health, outpatient, office visit" benefits. Always ask for the call reference number and the representative's name, and take note of the date, topic, and outcome of the call when you call insurance.
In-network Benefits
Is (provider name and NPI #) in-network for outpatient mental health/behavioral health with my health insurance?
What’s my in-network deductible for outpatient mental health services?
How much of my deductible has been met this year?
What is my copayment (copay) for outpatient mental health visits?
Is this coverage applicable before or after I meet my deductible?
Is there a limit on sessions my plan will cover per year? If Yes, How many?
Does my policy cover 53+ minute sessions (CPT code 90837 for Individual Therapy, and CPT code 90791)? If yes, how many?
What is the policy year (i.e. Jan 1 – Dec 31)?
Does my plan require pre-authorization for outpatient psychotherapy?
Do I have out-of-network outpatient mental health benefits?
Does my plan cover virtual / Telehealth outpatient mental health visits?
Out-of-network Benefits
We provide out-of-network services if we are not in-network with your insurance. These are some questions to ask your health insurance company:
Does my plan include out-of-network coverage for outpatient mental health services?
Is there an annual out-of-network deductible for outpatient mental health benefits? If so, how much?
How much of my out-of-network deductible has been met this year?
What is my out-of-network co-insurance percentage for outpatient mental health services?
Is there a limit on the number of sessions my plan will cover per year? If Yes, How many?
Is there a limit on out-of-pocket expenses per year?
Does my plan require pre-authorization for outpatient psychotherapy?
What is the policy year (i.e. Jan 1 – Dec 31)?
Do I need a referral from an in-network provider or a primary care physician to see someone out-of-network for psychotherapy?
How do I submit claims for out-of-network reimbursement?
Does my plan cover virtual / Telehealth outpatient mental health visits?
All fees are due on the day of the session. We charge our full session fee for out-of-network services, and we will issue you a superbill (upon your request) for you to submit to your insurance for possible reimbursements from your insurance. A superbill is like a receipt or an invoice that includes a diagnostic code.
If we are providing services as an in-network provider, you may have a copayment and it is due on the day of your session.
If you have to meet your in-network deductible, you may have to pay your full session fee. The full session fee varies depending on what your insurance coverage determines is the appropriate rate for it to cover. Paying for medical services and prescriptions will also contribute to your deductible.
If you have met your deductible, and you have a copayment fee, you only need to pay your copay fee before your session.
More information about insurance reimbursement is in our Informed Consent and our Fee Agreement and Payment Policy.
It is ultimately the client's responsibility to pay for their therapy services. Always verify with your insurance about your mental health benefits and refer to your contract with your insurance to understand your financial responsibility before scheduling your therapy sessions.